Thyroid lymphomas - Case 4: MALT-type lymphoma of the thyroid

Anaplastic carcinoma - Case 8

The sonographic presentation of these two cases is although similar, but not identical. A large hypoechogenic mass occupies almost the entire and the entire lobe, anaplastic carcinoma and MALT-lymphoma, respectively. There is a small echonormal intact part in the dosrsomedial part of the thyroid in the former case. Nevertheless, the difference is not enough to a clear distinction. The mass evolved over 6 months and over 2 months, MALT-lymphoma and anaplastic carcinoma, respectively.

The cytological pattern differs significantly: as a rule MALT lymphoma is very cellular and presents heterogeneous lymphoid cells. On the other hand, in the case of anaplastic carcinoma we not infrequently find only a few cells on the smears. These are dispersed, atypical pleomorphic forms.

Only anaplastic carcinoma and MALT-lymphoma are involved in the differential diagnostics of such rapidly increasing huge painless thyroid mass, while the cytological pattern decides the question. In the case of an extremely cellular heterogeneous lymphoid cell population only MALT-lymphoma and Hashimoto's thyroiditis are involved in the differential diagnostics. So combining the sonographic and cytological pattern we could give the diagnosis of suspicion of MALT-lymphoma in the left and a definitive diagnosis of anaplastic carcinoma in the right case.